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Ramírez SI, Partin M, Snyder AH, Ko E, Aruma J, Castaneda MC, Casas RS. A Scoping Review of Obstetrics and Gynecology Curricula in Primary Care Residency Programs. J Gen Intern Med 2024:10.1007/s11606-024-08987-1. [PMID: 39187722 DOI: 10.1007/s11606-024-08987-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 07/30/2024] [Indexed: 08/28/2024]
Abstract
BACKGROUND While Women's Health (WH) is a priority for primary care, (Family Medicine (FM), Internal Medicine (IM), Pediatrics (Peds), and combined Medicine/Pediatrics (Med/Peds)), residency curricula remain heterogeneous with deficits in graduates' WH expertise and skills. The overall objective of this study was to assess the quality of WH curricula at primary care residency programs in the United States (US), with a focus on topics in obstetrics and gynecology (OBGYN). METHODS PubMed®, ERIC, The Cochrane Library, MedEdPORTAL, and professional organization websites were systematically searched in 2019 and updated in 2021. Included studies described OBGYN educational curricula in US primary care residency programs. Following abstract screening and full-text review, data from eligible studies was abstracted and quality assessed using the Medical Education Research Study Quality Instrument (MERSQI). RESULTS A total of 109 studies met the inclusion criteria. Over a quarter of studies were interdepartmental or interdisciplinary. The most common single-department studies were IM (38%) and FM (26%). Twenty (25%) studies addressed comprehensive OBGYN curricula; the most common individual topics were cervical and breast cancer screening (31%) and contraception (16%). Most studies utilized multiple instructional modalities, most commonly didactics (54%), clinical experiences (41%), and/or simulation (21%). Most studies included self-reported outcomes by residents (70%), with few (11%) reporting higher-level assessments (i.e., patient, or clinical outcomes). Most studies were single-group pre- and post-test (42%) with few randomized controlled trials (4%). The mean MERSQI score for studies with sufficient data (90%) was 9.8 (range 3 to 15.5). DISCUSSION OBGYN educational curricula for primary care trainees in the US was varied with gaps in represented residents, content, assessments, and study quality.
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Affiliation(s)
- Sarah I Ramírez
- Department of Family and Community Medicine, Penn State College of Medicine, 500 University Drive; HP 11, Hershey, PA, 17033, USA.
| | - Michael Partin
- Department of Family and Community Medicine, Penn State College of Medicine, 500 University Drive; HP 11, Hershey, PA, 17033, USA
| | - Ashley H Snyder
- Internal Medicine, Penn State College of Medicine, Hershey, PA, USA
| | - Elizabeth Ko
- Internal Medicine, Penn State College of Medicine, Hershey, PA, USA
| | - Jane Aruma
- Anesthesiology, Northwestern University, Evanston, IL, USA
| | - Marie C Castaneda
- Harrell Health Sciences Library: Research and Learning Commons, Penn State College of Medicine, Hershey, PA, USA
| | - Rachel S Casas
- Internal Medicine, Penn State College of Medicine, Hershey, PA, USA
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Ruelle Y, Haghighi S, Guillot O. Effects of a short training workshop on the insertion/removal of intrauterine devices and contraceptive implants by general practice residents and their supervisors in France. Contraception 2023; 127:110117. [PMID: 37467922 DOI: 10.1016/j.contraception.2023.110117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 06/29/2023] [Accepted: 07/03/2023] [Indexed: 07/21/2023]
Abstract
OBJECTIVES The skill of general practitioners (GPs) in performing the insertion/removal of intrauterine devices (IUDs) and contraceptive implants is one of the factors that determines patient's access to these contraceptive devices. In France, GP residents have few opportunities to perform these procedures during their internships. This study aimed to measure the effects of a single short training workshop on the number of residents and supervisors offering these procedures. STUDY DESIGN Each participant attended a unique 2-hour session. After a brief didactic review and video presentations, participants received hands-on training in technical procedures (insertion/removal of IUDs and contraceptive implants) using procedural simulators. The evaluation measured the number of GPs offering these procedures before, 1 month after, and 3 months after the workshops. RESULTS Fourteen sessions were organized from February 2017 to June 2022. Among the 387 residents and 123 supervisors invited, 143 (37.0%) and 56 (45.5%), respectively, participated in this workshop. Of 199 participants, 66.3% completed all questionnaires. There was a significant increase in the number of GPs inserting IUDs by direct method 3 months after training (20.5% vs 9.0%, p = 0.005). GPs providing information to patients about contraceptive implants were significantly higher at 1 month (80.6% vs 64.8%, p = 0.001) but this increase was no longer significant at 3 months (75.0%, p = 0.07). Residents changed their practices more than their supervisors, and women more than men. CONCLUSIONS A short training workshop increased the number of GPs inserting IUDs, influenced by the gender and the number of years practicing. IMPLICATIONS A single workshop had positive effects on IUD insertion and patient education about contraceptive implants. Repeating several times this training could be an option in the initial and ongoing training of general practitioners. Work on the general practitioners' own feeling of legitimacy in their practice context could also increase the effectiveness of these workshops and the practical implementation of the procedures taught.
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Affiliation(s)
- Yannick Ruelle
- Université Sorbonne Paris Nord, Département Universitaire de Médecine Générale, DUMG, Villetaneuse, France; Université Sorbonne Paris Nord, Laboratoire Educations et Promotion de la Santé, LEPS, UR 3412, Villetaneuse, France; Centres Municipaux de Santé Universitaires, Pantin, France.
| | - Sophie Haghighi
- Université Sorbonne Paris Nord, Département Universitaire de Médecine Générale, DUMG, Villetaneuse, France; Centres Municipaux de Santé Universitaires, Pantin, France
| | - Ophélie Guillot
- Université Sorbonne Paris Nord, Département Universitaire de Médecine Générale, DUMG, Villetaneuse, France; Centre Municipal de Santé, Livry-Gargan, France
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de Araújo DP, Duarte JL, Araújo ES. Virtual Patients: Impact of Computer Simulation on Audiology Learning and Practice. Am J Audiol 2023; 32:604-613. [PMID: 37591217 DOI: 10.1044/2023_aja-22-00242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/19/2023] Open
Abstract
PURPOSE The purpose of this study was to verify users' satisfaction with the interface of an audiometric simulator and self-perception of the computer simulation impact on practical acting in audiology, allowing the identification of problems and possibilities for improvement. METHOD A prospective, observational study was divided into two phases: The first is evaluating the student's satisfaction, using the simulator in the theoretical and practical learning of audiology, and the second one is assessing the self-perception of the simulator's impact on the practical performance of audiology. The sample comprised 35 students from two Speech-Language Pathology and Audiology courses, in Brazil, selected by convenience, who answered the questionnaire after completing the theoretical module, using Google Forms, without any identification. RESULTS In the first phase of the study, students positively evaluated the use of the simulator as an auxiliary tool for audiology learning, and in the second one, they also positively assessed the impact of training with the simulator in audiological practice. CONCLUSION The analyzed audiometric simulator proved to be an interactive system with high acceptability, level of satisfaction, and potential impact on practical performance in audiology. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.23876325.
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Affiliation(s)
- Deuzimar Pires de Araújo
- Graduate Program in Speech, Language, and Hearing Sciences, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Josilene Luciene Duarte
- Department of Speech-Language Pathology and Audiology, Federal University of Sergipe, Lagarto, Brazil
| | - Eliene Silva Araújo
- Department of Speech-Language Pathology and Audiology, Natal, Rio Grande do Norte, Brazil
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Boev C. Next Generation NCLEX: Why Simulation Matters. J Nurs Educ 2023; 62:285-289. [PMID: 37146046 DOI: 10.3928/01484834-20230306-04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
BACKGROUND The Next Generation NCLEX (NGN) is designed to specifically measure nursing clinical judgment. Schools of nursing are looking for ways to better integrate nursing clinical judgment into their curriculum. One effective strategy to promote nursing clinical judgment is simulation. METHOD This article explains how to conduct simulations that follow the National Council of State Boards of Nursing Clinical Judgment Measurement Model (NCJMM). Focusing on layer three of the NCJMM, specific examples are provided that link each step of layer three to nursing clinical judgment using simulation. RESULTS Beginning with Recognizing Cues, the simulation focuses on each step of layer three ending with Evaluating Outcomes. The simulation concludes with a debriefing session to solidify relationships between the variables. CONCLUSION Simulation has the potential to improve nursing clinical judgment as well as pass rate on the NGN. [J Nurs Educ. 2023;62(5):285-289.].
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Xia J, Mao J, Chen H, Xu X, Zhang J, Yang J, Wang Z. Development and evaluation of a portable and soft 3D-printed cast for laparoscopic choledochojejunostomy model in surgical training. BMC MEDICAL EDUCATION 2023; 23:77. [PMID: 36721193 PMCID: PMC9889129 DOI: 10.1186/s12909-023-04055-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 01/24/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Laparoscopic choledochojejunostomy (LCJ) is an essential basic skill for biliary surgeons. Therefore, we established a convenient and effective LCJ 3D printing model to evaluate whether the model could simulate the actual operation situation and determine its effectiveness and validity in surgical training. METHODS A 3D printing dry laboratory model was established to simulate LCJ. The face and content validity of the model were evaluated by six experienced biliary surgeons based on 5-point Likert scale questionnaires. A total of 15 surgeons with different levels of experience performed LCJ on the model and evaluated the structural validity of the model using the objective structured assessment of technical skills (OSATS). Simultaneously, the operation time of each surgery was also recorded. A study was also performed to further evaluate the learning curve of residents. RESULTS The operating space score of the model was 4.83 ± 0.41 points. The impression score of bile duct and intestinal canal was 4.33 ± 0.52 and 4.17 ± 0.41 points, respectively. The tactile sensation score of bile duct suture and intestinal canal suture was 4.00 ± 0.63 and 3.83 ± 0.41points, respectively. The OSATS score for model operation in the attending group was 29.20 ± 0.45 points, which was significantly higher than that in the fellow group (26.80 ± 1.10, P = 0.007) and the resident group (19.80 ± 1.30, P < 0.001). In addition, there was a statistical difference in operation time among surgeons of different experience levels (P < 0.05). Residents could significantly improve the surgical score and shorten the time of LCJ through repeated training. CONCLUSIONS The 3D printing LCJ model can simulate the real operation scenes and distinguish surgeons with different levels of experience. The model is expected to be one of the training methods for biliary tract surgery in the future.
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Affiliation(s)
- Jianfu Xia
- Department of General Surgery, The Second Affiliated Hospital of Shanghai University (Wenzhou Central Hospital), Wenzhou, 325000, China
- Soochow University, Suzhou, 215000, China
- General Surgery, Cancer Center, Department of Hepatobiliary & Pancreatic Surgery and Minimally Invasive Surgery, Zhejiang Provincial People's Hospital, Hangzhou, 310000, China
| | - Jinlei Mao
- The Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, 310000, China
| | - Hao Chen
- The Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, 310000, China
| | - Xiaodong Xu
- College of Materials Science and Engineering, Zhejiang University of Technology, Hangzhou, 310014, China
| | - Jing Zhang
- College of Materials Science and Engineering, Zhejiang University of Technology, Hangzhou, 310014, China
| | - Jin Yang
- Department of General Surgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, 310000, China
| | - Zhifei Wang
- General Surgery, Cancer Center, Department of Hepatobiliary & Pancreatic Surgery and Minimally Invasive Surgery, Zhejiang Provincial People's Hospital, Hangzhou, 310000, China.
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El Hussein MT, Favell D. Simulation-Based Learning in Nurse Practitioner Programs: A Scoping Review. J Nurse Pract 2022. [DOI: 10.1016/j.nurpra.2022.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Nye C. State of Simulation Research in Advanced Practice Nursing Education. ANNUAL REVIEW OF NURSING RESEARCH 2020; 39:33-51. [PMID: 33431636 DOI: 10.1891/0739-6686.39.33] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Simulation is used in advanced practice nursing education for both formative learning experiences and summative competency testing. However, there has been a lack of cohesive data to support the use of simulation as a replacement for direct patient care hours. This chapter presents an overview of research designs and the leveled Kirkpatrick framework used in simulation research. Research articles evaluating the effect of simulation on advanced practice learners are presented by research design and Kirkpatrick level. There is evidence that simulation has a positive impact on Kirkpatrick Level 1 (Reactions) and Kirkpatrick Level 2 (Changes in Knowledge, Skills, and Attitudes). However, there is a tremendous need for evidence that simulation can impact Kirkpatrick Level 3 (Behavior) and Level 4 (Results and Outcomes).
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Abstract
Simulation-based education improves health care professionals' performance in managing critical events. Limitations to widespread uptake of high-fidelity simulation include barriers related to training, technology, and time. Alternatives to high-fidelity simulation that overcome these barriers include in situ simulation, classroom-based simulation, telesimulation, observed simulation, screen-based simulation, and game-based simulation. Some settings have limited access to onsite expert facilitation to design, implement, and guide participants through simulation-based education. Alternatives to onsite expert debriefing in these settings include teledebriefing, scripted debriefing, and within-group debriefing. A combination of these alternatives promotes successful implementation and maintenance of simulation-based education for managing critical health care events.
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Affiliation(s)
- Megan Delisle
- Department of Surgery, University of Manitoba, 347-825 Sherbrook Street, Winnipeg, Manitoba R3T 2N2, Canada
| | - Alexander A Hannenberg
- Ariadne Labs, Tufts University School of Medicine, 401 Park Drive, 3 West, Boston, MA 02115, USA.
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Linganna RE, Goldhammer JE. OMG! Andragogy for Millennials. J Cardiothorac Vasc Anesth 2020; 34:1250-1251. [DOI: 10.1053/j.jvca.2020.01.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Accepted: 01/09/2020] [Indexed: 11/11/2022]
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Field C, Benson LS, Stephenson-Famy A, Prager S. Intrauterine Device Training Workshop for Preclinical Medical Students. MEDEDPORTAL : THE JOURNAL OF TEACHING AND LEARNING RESOURCES 2019; 15:10841. [PMID: 31911932 PMCID: PMC6944262 DOI: 10.15766/mep_2374-8265.10841] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Accepted: 06/11/2019] [Indexed: 06/10/2023]
Abstract
INTRODUCTION Medical school reproductive health curricula often lack adequate education regarding intrauterine devices (IUDs). When placed in clinical scenarios, students may have insufficient knowledge and training to counsel patients about IUDs. METHODS We developed a workshop for preclinical medical students and assessed whether it improved knowledge of and comfort with counseling patients on IUDs. The workshop consisted of a 45-minute lecture and a 45-minute IUD simulation training. Each session was taught to groups of 40 to 50 students. The workshop was evaluated between January 2016 and November 2017. Participants completed pre- and postsurveys. The primary outcome was comfort level with IUD counseling. RESULTS One hundred forty-two students completed the workshop, and 137 completed both pre- and postsurveys (96% response rate). At baseline, more than half (56%, n = 77) had not seen an IUD inserted. Students scoring 75% or higher on the IUD knowledge questions increased from 51% (n = 70) on presurveys to 87% (n = 119) on postsurveys (p < .0001). Students agreeing or strongly agreeing that they felt comfortable counseling patients on IUDs increased from 27% (n = 37) to 92% (n = 122, p < .0001) on postsurveys. All students felt the workshop was worthwhile. DISCUSSION Preclinical students showed increased knowledge of and comfort with IUDs after a simple IUD simulation. Medical schools could utilize this workshop to ensure students have hands-on training and experience related to IUDs prior to clinical rotations and for their future careers.
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Affiliation(s)
- Carlie Field
- Resident Physician, Department of Obstetrics and Gynecology, University of Washington Medical Center
| | - Lyndsey S. Benson
- Assistant Professor, Department of Obstetrics and Gynecology, University of Washington Medical Center
| | - Alyssa Stephenson-Famy
- Associate Professor, Department of Obstetrics and Gynecology, University of Washington Medical Center
| | - Sarah Prager
- Professor, Department of Obstetrics and Gynecology, University of Washington Medical Center
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Vidal F, Paret L, Linet T, Tanguy le Gac Y, Guerby P. [Intrauterine contraception: CNGOF Contraception Guidelines]. ACTA ACUST UNITED AC 2018; 46:806-822. [PMID: 30429071 DOI: 10.1016/j.gofs.2018.10.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To provide national clinical guidelines focusing on intrauterine contraception. METHODS A systematic review of available literature was performed using Pubmed and Cochrane libraries. American, British and Canadian guidelines were considered as well. RESULTS Intrauterine contraception (IUC) displays a wide panel of indications, including adolescents, nulliparous, patients living with HIV before AIDS (Grade B) and women with history of ectopic pregnancy (Grade C). Cervical cancer screening should not be modified in women with IUC (Grade B). Bimanual examination and cervix inspection are mandatory before device insertion (Grade B). Patients should not systematically undergo screening for sexually transmitted infections (STI) before device insertion (Grade B). Screening for STI should be preferably done before insertion but it can be performed at the time of device insertion in asymptomatic women (Grade B). Routine antibiotic prophylaxis and premedication are not recommended before insertion (Grade A). A follow-up visit may be offered several weeks after insertion (Professional consensus). Routine pelvic ultrasound examination in not recommended after device insertion (Grade B). In patients with IUC, unscheduled bleeding, when persistent or associated with pelvic pain, requires further investigation to rule out complication (Professional agreement). Suspected uterine perforation warrants radiological workup to locate the device (Professional consensus). Laparoscopic approach should be preferred for elective removal of intrauterine device from abdominal cavity (Professional consensus). In case of accidental pregnancy with intrauterine device in situ, ectopic pregnancy should be excluded (Grade B). In case of viable and desired intrauterine pregnancy, intrauterine device removal is recommended if the strings are reachable (Grade C). Detection of Actinomyces-like organisms on pap smear in asymptomatic patients with intrauterine contraception does not require further intervention (Grade B). Immediate removal of intrauterine device is not recommended in case of STI or pelvic inflammatory disease (Grade B). Device removal should be considered in the absence of clinical improvement after 48 to 72 hours of appropriate treatment (Grade B). CONCLUSION Intrauterine contraception is a long-acting and reversible contraception method displaying great efficacy and high continuation rate. In contrast, complication rate is low. It should thus be offered to both nulliparous and multiparous women.
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Affiliation(s)
- F Vidal
- Pôle Femme Mère Couple, hôpital Paule-de-Viguier, CHU Purpan, 330, avenue de Grande-Bretagne, 31059 Toulouse, France; Université Toulouse III, 118, route de Narbonne, 31062 Toulouse, France.
| | - L Paret
- Pôle Femme Mère Couple, hôpital Paule-de-Viguier, CHU Purpan, 330, avenue de Grande-Bretagne, 31059 Toulouse, France; Université Toulouse III, 118, route de Narbonne, 31062 Toulouse, France
| | - T Linet
- Service de gynécologie-obstétrique, centre hospitalier Loire-Vendée-Océan, 85300 Challans, France
| | - Y Tanguy le Gac
- Pôle Femme Mère Couple, hôpital Paule-de-Viguier, CHU Purpan, 330, avenue de Grande-Bretagne, 31059 Toulouse, France
| | - P Guerby
- Pôle Femme Mère Couple, hôpital Paule-de-Viguier, CHU Purpan, 330, avenue de Grande-Bretagne, 31059 Toulouse, France; Université Toulouse III, 118, route de Narbonne, 31062 Toulouse, France
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Rubin SE, Maldonado L, Fox K, Rosenberg R, Wall J, Prine L. Establishing and Conducting a Regional, Hands-on Long-Acting Reversible Contraception Training Center in Primary Care. Womens Health Issues 2018; 28:375-378. [PMID: 29891213 DOI: 10.1016/j.whi.2018.04.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Revised: 04/26/2018] [Accepted: 04/26/2018] [Indexed: 01/28/2023]
Affiliation(s)
- Susan E Rubin
- The Institute for Family Health, New York, New York.
| | | | - Kelita Fox
- Unity Family Medicine at Orchard Street, Rochester, New York
| | | | - Jacqueline Wall
- Columbia University School of Public Health, New York, New York
| | - Linda Prine
- The Institute for Family Health, New York, New York; Reproductive Health Access Project, New York, New York
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